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Government proposes extending working hours of doctors

The Ministry of Health has proposed extending working hours for doctors to up to 48 hours a week in order to resolve the labour shortage caused in part by the new Labour Code, which came into force in January 2007. The ministry wants to take the opportunity to pass technical amendments to the Labour Code in parliament in order to make these changes. However, trade unions as well as professional organisations are threatening to protest against such a proposal.

Effect of new Labour Code

The new Labour Code took effect on 1 January 2007. Unlike the previous piece of legislation, it does not contain the term ‘work on standby’, meaning the period spent by the employee waiting for work at the place of the employer; such work is no longer added to the overtime work limit but counted as regular working hours (CZ0702079I). Due to the fact that doctors covering night shifts – in particular at hospitals and medical emergency services – work hundreds of hours of overtime, the problem arose that the reduced overtime limit was used up relatively quickly.

The change in the Labour Code has also resulted in hospitals experiencing an increase in wage costs, as work on standby must now be paid at the standard rate of pay, rather than half-pay. At the moment, this problem is often being resolved in a way that falls just within the framework of the law: by concluding supplementary individual agreements on work performed during overtime shifts – in other words, agreements on work activity – with the employees (CZ0702079I).

‘Opt-out’ provision for healthcare workers

The Ministry of Health (Ministerstvo zdravotnictví, MZCR) proposes to resolve the problem by amending the Labour Code to include an ‘opt-out’ provision from regulations on working time and breaks for healthcare employees, including doctors and non-medical healthcare staff. This would allow employers to adjust the working time from the current 40 hours a week to 48 hours a week, which will in effect amount to a total of 56 hours a week counting overtime. The Minister of Health, Tomáš Julínek of the Civic Democratic Party (Občanská demokratická strana, ODS), emphasises that the adjustment of working hours should be conditional on the employee’s consent.

Disapproval of professional and trade union organisations

The professional organisation the Czech Medical Chamber (Česká lékařská komora, ČLK), of which all doctors in the Czech Republic are legally required to be members, as well as the two largest trade unions active in healthcare – the Trade Union of Doctors in the Czech Republic (Lékařský odborový klub-Svaz českých lékařů, LOK-SČL) and the Health and Social Care Trade Union (Odborový svaz zdravotnictví a sociální péče, OSZSP) – are against the minister’s proposal. Both ČLK and the trade unions believe that the proposal for adjustment of working hours differs from what is stipulated in the Charter of Rights and Freedoms, the Labour Code and, in particular, Directive 2003/88/EC of the European Parliament and of the Council concerning certain aspects of the organisation of working time.

Moreover, trade union organisations do not agree with the decrease in financial remuneration that would be caused by the transfer of the eight working hours from overtime hours to basic working hours, that is, by adjusting the standard working time from 40 hours to 48 hours a week. Furthermore, according to ČLK, the proposed amendment does not sufficiently address the fact that doctors and other healthcare workers may be pressurised to accept longer working time.

The political opposition, the Czech Social Democratic Party (Česká strana sociálně demokratická, ČSSD), is also fundamentally opposed to the government proposal.

Trade union protests

Minister Julínek intended to push through the change to the technical amendment of the Labour Code to which the social partners had agreed in the spring of 2007 (CZ0706029I). After negotiations with OSZSP, however, he backed down from this step; nonetheless, the trade union has drawn attention to the fact that the minister is now trying to pass the technical amendment to the Labour Code in the next phase of the legislative process – in the Senate of the Parliament of the Czech Republic.

In response, OSZSP is currently leading negotiations with the employers and is proposing to increase temporarily the limit of overtime hours for doctors and healthcare personnel in order to address the problem that arose regarding the reduced overtime limit. Meanwhile, LOK-SČL is planning to strike if Minister Julínek’s proposal is adopted and ČLK has already expressed its support for the protests. OSZSP would first like to wait for the results of the negotiations with the employers and the government; nevertheless, it has also expressed its disagreement with the minister’s action.

Commentary

The issue of overtime work in healthcare has long been neglected, and changes in work organisation are necessary. OSZSP has highlighted this problem for some time and is calling for a concrete solution. A part of this solution should include an increase in the standard rate of pay to prevent doctors from being forced to work an excessive amount of overtime hours.

Ondřej Novák, Research Institute for Labour and Social Affairs (RILSA)